Objective: To research the association between exposure to solid fuels for heating and its duration and the risk of respiratory diseases morbidity. Methods: Data from the China Kadoorie Biobank project sited in Pengzhou City, Sichuan Province. Cox proportional hazard regression model was used to analyze the association between exposure to solid fuels for heating and its duration and the risk of total respiratory diseases and the association between exposure to solid fuels for heating and the risk of chronic obstructive pulmonary disease (COPD) and pneumonia among respiratory diseases. Results: A total of 46 082 participants aged 30-79 years were enrolled, with 11 634 (25.25%) heating during the winter, of whom 8 885 (19.28%) used clean fuels and 2 749 (5.97%) used solid fuels, of whom 34 448 (74.75%) did not heat. After controlling for multiple confounding factors, Cox proportional hazard regression model was used, which revealed that compared with clean fuels, unheating could reduce the risk of total respiratory disease (HR=0.81,95%CI:0.77-0.86), COPD (HR=0.86,95%CI:0.78-0.95) and pneumonia (HR=0.80,95%CI:0.74-0.86), respectively. Exposure to solid fuels increased the risk of total respiratory disease (HR=1.10, 95%CI:1.01-1.20) and were not associated with COPD and pneumonia. Compared with no solid fuel exposure, the risk of total respiratory disease (1-19 years:HR=1.23, 95%CI:1.10-1.37; 20-39 years:HR=1.25, 95%CI:1.16-1.35; ≥40 years:HR=1.26, 95%CI:1.15-1.39) and COPD (1-19 years: HR=1.21, 95%CI:1.03-1.42; 20-39 years: HR=1.30, 95%CI:1.16-1.46; ≥40 years:HR=1.35, 95%CI:1.18-1.54) increased with the length of exposure of solid fuels (trend test P<0.001). Solid fuels exposure for 1-19 years and 20-39 years increased the risk of COPD by 23% (HR=1.23,95%CI:1.02-1.49) and 16% (HR=1.16, 95%CI:1.00-1.35). Conclusion: Heating solid fuels exposure increases the risk of total respiratory disease, COPD, and pneumonia.
目的： 探讨取暖固体燃料暴露及其时长与呼吸系统疾病发病风险之间的关联。 方法： 利用中国慢性病前瞻性研究四川省彭州市项目点数据，采用Cox比例风险回归模型分析取暖固体燃料暴露及其时长与总呼吸系统疾病发病风险之间的关联，进一步分析其与呼吸系统疾病中慢性阻塞性肺疾病（COPD）、肺炎发病风险之间的关联。 结果： 共纳入46 082名30~79岁研究对象，冬季11 634名（25.25%）进行取暖，其中8 885名（19.28%）使用清洁燃料，2 749名（5.97%）使用固体燃料；34 448名（74.75%）不取暖。控制多个混杂因素后，Cox比例风险回归模型分析显示，与清洁燃料相比，不取暖降低总呼吸系统疾病（HR=0.81，95%CI：0.77~0.86）、COPD（HR=0.86，95%CI：0.78~0.95）、肺炎（HR=0.80，95%CI：0.74~0.86）的发病风险；固体燃料暴露增加总呼吸系统疾病的发病风险（HR=1.10，95%CI：1.01~1.20），与COPD、肺炎的发病风险无统计学关联。与没有固体燃料暴露相比，随着固体燃料暴露时长增加，总呼吸系统疾病（1~19年：HR=1.23，95%CI：1.10~1.37；20~39年：HR=1.25，95%CI：1.16~1.35；≥40年：HR=1.26，95%CI：1.15~1.39）及肺炎（1~19年：HR=1.21，95%CI：1.03~1.42；20~39年：HR=1.30，95%CI：1.16~1.46；≥40年：HR=1.35，95%CI：1.18~1.54）发病风险增加（趋势检验均P<0.001）；固体燃料暴露时长1~19、20~39年使COPD的发病风险增加23%（HR=1.23，95%CI：1.02~1.49）、16%（HR=1.16，95%CI：1.00~1.35）。 结论： 取暖固体燃料暴露增加了总呼吸系统疾病、COPD、肺炎的发病风险。.